Provider Demographics
NPI:1871898775
Name:VILLARREAL, MARGUERITE MARY (PT, DPT)
Entity type:Individual
Prefix:MRS
First Name:MARGUERITE
Middle Name:MARY
Last Name:VILLARREAL
Suffix:
Gender:F
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:31 HORSESHOE LN
Mailing Address - Street 2:
Mailing Address - City:LEMONT
Mailing Address - State:IL
Mailing Address - Zip Code:60439-9110
Mailing Address - Country:US
Mailing Address - Phone:708-267-8171
Mailing Address - Fax:
Practice Address - Street 1:31 HORSESHOE LN
Practice Address - Street 2:
Practice Address - City:LEMONT
Practice Address - State:IL
Practice Address - Zip Code:60439-9110
Practice Address - Country:US
Practice Address - Phone:708-267-8171
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-01-24
Last Update Date:2024-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL0700169432251P0200X
IL070.016943225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
No2251P0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistPediatrics